Hallmark symptoms are a sudden increase in floaters, flashes of light (photopsia), and a curtain or veil over part of vision.
Before you read
Test yourself first: 2 questions
Question 1 of 2
A nurse assesses an older adult for normal age-related vision changes. Which finding is an expected change of aging?
Answer: B. Presbyopia, the decreased ability to focus on near objects, is a normal age-related vision change. Sudden painless vision loss, halos with eye pain, and a curtain over the visual field are signs of pathology (such as retinal detachment or acute glaucoma), not normal aging.
Question 2 of 2
A nurse is in the third stage of labor with a client. Which finding is a sign that the placenta has separated and is ready to be delivered?
Answer: B. Signs of placental separation include a sudden gush of blood, lengthening of the umbilical cord at the introitus, and the uterus rising upward and becoming firm and globular. These indicate the placenta has detached.
Keep the streak going with more questions like these, each with a full rationale.
What is detached retina?
It is a painless ophthalmic emergency that, if untreated, leads to permanent vision loss in the affected eye. Classic warning symptoms are sudden floaters, light flashes, and a curtain or shadow moving across the field of vision. Risk factors include aging, severe myopia, eye trauma, cataract surgery, and diabetes.
Key points to remember
- Hallmark symptoms are a sudden increase in floaters, flashes of light (photopsia), and a curtain or veil over part of vision.
- The condition is painless, which can delay patients from seeking care.
- Loss of vision corresponds to the area of detachment and progresses as more retina detaches.
- Risk factors include high myopia, advancing age, blunt eye trauma, diabetes, and prior eye surgery.
- Detachment cuts off retinal blood supply, so prompt repair is critical to save vision.
Signs & symptoms
- Sudden floaters + light flashes
- Curtain/shadow over visual field
- Painless vision loss
Nursing priorities
- Recognize the emergency and arrange immediate ophthalmology evaluation; vision loss can be permanent without prompt repair.
- Maintain bed rest and position the patient's head as ordered so the detached area is dependent (gravity helps reattachment).
- Limit eye movement and activity; apply an eye patch if ordered to reduce stimulation before surgery.
- Postoperatively (e.g., gas tamponade), maintain the prescribed positioning, often face-down, for the ordered time.
- Administer prescribed medications and provide a safe, calm environment to limit head movement.
Patient teaching
- Seek care immediately for sudden flashes, floaters, or a shadow over your vision; do not wait because it is painless.
- Maintain the prescribed head position after surgery and avoid heavy lifting, bending, and straining.
- If a gas bubble was placed, do not fly or travel to high altitudes until cleared by the surgeon.
Red flags: report now
- Sudden flashes, a shower of floaters, or a curtain across vision require emergency ophthalmology referral.
- After gas bubble injection, air travel and high altitude are prohibited until the gas absorbs (risk of vision loss).
- Increasing pain, redness, or sudden total vision loss after repair must be reported immediately.
- Do not allow vigorous activity, bending, or straining that could worsen detachment.
References
Clinical references for this topic
